How Covid-19 testing saved lives
University of Sussex research provides clear evidence that high-capacity, responsive test, trace and isolate systems can prevent deaths in a pandemic.
As the Covid-19 Inquiry reflects on the UK’s response to the pandemic, international comparisons by University of Sussex researchers are providing valuable insights about two key aspects of the UK’s approach – test, trace and isolate (TTI) systems and screening of international travellers. Their analysis of different countries’ responses to the pandemic provides vital lessons for future pandemic planning and preparedness.
Following the advice of the World Health Organization to “test, test, test” early in the pandemic, national TTI systems were adopted on an unprecedented scale and at great expense. The UK reached one of the highest testing rates in Europe, yet its TTI system faced criticism, particularly due to the high costs of testing, as highlighted by the Public Accounts Committee.
The Optimising Coronavirus Testing Systems (OCTS) project, led by Michael Hopkins, Professor of Innovation Management at the University of Sussex, analysed TTI systems in the UK, Australia, Canada, Germany, Ireland, Spain, South Africa, and South Korea. The team discovered that high rates of testing led to a clear reduction in the number of excess deaths – a measure strongly related to Covid-19 mortality during the study period.
Testing one additional person per hundred each week was associated with a decline of just over two excess deaths per million people three weeks later. In other words, in an average week between 2020-2022, across countries, each additional 5,000 Covid tests saved one life.
“Our findings demonstrate the importance of high-capacity TTI systems and the need for rapid scale-up of testing in the face of emerging and re-emerging viruses,” says Professor Hopkins. “The positive effects of testing may be enhanced by the specific design of TTI systems, which is why international comparisons remain important.”
The study also found that high test positivity rates were associated with more excess deaths. “High positivity rates indicate either high levels of circulating infection or overwhelmed testing services,” explains Professor Hopkins. “This makes positivity rates a useful tool for monitoring the functioning of TTI systems.”
Screening of international travellers
Testing international travellers was a key element of pandemic responses around the world. All countries in the OCTS study used private services to screen international travellers prior to departure, although in the UK these often proved difficult to accredit and monitor, with poor quality testing and high prices. Testing for incoming travellers was better integrated with domestic public health services, but these sometimes lacked capacity during spikes in domestic cases.
“Overall, national governments allocated more resources to stopping the virus from entering their countries than to preventing departing travellers from exporting the infection to the rest of the world,” explains Professor Hopkins. “We encourage policymakers to reflect on the purpose and implementation of border screening, especially on the role of affluent countries in reducing the export of infection to more vulnerable regions.”
About the project
The OCTS project was undertaken by a group of scientists, social scientists and clinicians, and was funded through UK Research & Innovation’s Covid-19 programme. See www.octs.info
Policy@Sussex
The project is supported by Policy@Sussex, which connects University of Sussex researchers with policymakers. To find out more, contact policyteam@sussex.ac.uk, follow @Policy_Sussex on Twitter or visit www.sussex.ac.uk/research/about/policy-at-sussex
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